Child
Development
Dr: Ehab Abd
El-Kafy
Child development:
-----Fine (Manipulation)
MOTOR {
-----Gross (Mobility)
-----Speech (Expression)
LANGUAGE {
-----Understanding (Receptive)
VISION
HEARING
COGNITIVE
perceptual
SOCIAL
BEHAVIOUR
-1-
New gross and fine motor skills are definitely
learned and refined after age 2.
Gestational and postgestational motor development
usually occur according to a typical sequence,
pattern, and timing.
However, after birth, extrinsic factors such as
opportunity to learn and practice a skill, exposure to
environmental pollutants, inadequate nurture and
bonding, and culture may modify age of skill
acquisition and possibly the sequence and pattern of
the motor behaviors.
-3-
The Variability of Human Growth and
Development
Human development is characterized by variability.
Motor development and motor behaviors vary
because of the influence of numerous intrinsic
(endogenous) and extrinsic (exogenous) factors,
many of which we cannot influence or control.
-5-
Examples of Extrinsic Factors That Affect
Motor Development
Factor Example
Opportunity Stair climbing develops earlier in a child
who must contend with stairs in the
home, compared to children who are not
permitted on stairs.
Environmental Children raised in an environment of
smoke from cigarette smoking may be
pollutants delayed in developing motor skills and
may have stunted growth.
-6-
Examples of Extrinsic Factors That Affect
Motor Development
Factor Example
Inadequate nurture Infants who are not held to be
and bonding fed may experience motor
delay as well as failure to
thrive.
Parental and cultural Children placed supine to sleep
childrearing practices may be slower to develop head
control in prone and upright,
prone-on-elbows posture, and
rolling prone to supine.
-7-
Developmental Theories
Developmental theories have been applied to all
aspects of infant and child development including
physical, psychosocial, and cognitive.
To effectively work with children, physical therapists
need to have a broad understanding of all areas of
infant and child development.
However, physical therapists most definitely need a
broad and deep understanding of the physical
aspects of growth and development.
Therefore, those developmental theories that
adequately address a child's physical development
are easiest to apply in physical therapy. -8-
1-Maturational Theories
Maturational theories , also referred to as
hierarchical theories.
Maturational theories of development emphasize a
normal developmental sequence that is common to
all fetal, infant, and child mental and motor
development.
According to maturationists , the normal sequence
of development evolves as the central nervous
system (CNS) matures, and the CNS is the major
driving force of development.
-9-
2-Behavioral theory of development
A behavioral theory of development is rooted in the
works of Pavlov, Stunner, and Bandura, with
emphasis on conditioning behavior through the use
of a stimulus-response approach.
Behavior theory advocates modifying behavior
through manipulating stimuli in the environment to
create a response that positively or negatively
reinforces a particular behavior.
This type of theory is used by physical therapists
when they control the environment to elicit a
predictable behavior.
-10-
3-Dynamic systems theories
This theory is based on the original work of
Bernstein in 1967 and has been modified by
numerous others more recently.
Unlike the longitudinal and hierarchical maturation
theories, which consider the CNS to be the
predominate factor and manager and regulator of
development, dynamic systems theories see infant
and child development as nonlinear and the result of
many factors, both intrinsic and extrinsic, that
impact the developing fetus and child.
According to the dynamic systems theory, no one
system is the preeminent director of development.
Instead, each fetus and child develops certain
characteristics and skills based on the confluence of
many factors. -11-
Factors that influence motor development in the
human include :
- Genetic inheritance, errors and mutations in genetic
transmission,
- poor maternal/fetal and child nutrition, fetal and
- Infant exposure to toxins and other chemical substances,
- Race, ethnicity,
- Presence or absence of quality prenatal care,
-Childrearing practices,
- Socioeconomic level ,
- Disease processes, and trauma. In addition,
- Opportunity for practice skill,
-Cognitive abilities,
- Level of stimulation, and motivation affect the learning of
new motor skills in children and adults, as do the motor task at
hand,
- The functional outcome desired, and
- the context for using a particular motor skill.
-12-
In a dynamic systems view of growth and
development, the CNS is merely one, albeit very
important, influential system.
Unlike a purely hierarchical or maturational
viewpoint, a dynamic systems approach to
development considers the profound influences of
other body systems on the anatomic, physiologic,
and behavioral qualities of the fetus and child (the
organism).
These other systems include:
The peripheral nervous,
The musculoskeletal,
The cardiopulmonary, and
The integumentary systems.
-13-
Which developmental theory is correct?
Among the many theories of development, including those
affecting motor development, probably no one theory can ever
be considered the one and only correct theory.
Rather, many different theories can be called upon to explain
and predict fetal and child motor development.
Principles from different theories can be combined to analyze,
interpret, and even predict motor development.
Many aspects of the dynamic systems approach probably come
the closest to being the dominant theory of motor development
used by physical therapists in the 21st century, because this
approach, in itself, considers the impact of many variables on
the creation, growth, and development of a human biologic
system.
-14-
Principles of development direction
1-Reflex control before cortical control.
2-Total response before localized response.
3-Cephalic control before caudal.
An exception to cephalocaudal development is the development
of muscle tone in the fetus. Studies of premature infants have shown
that muscle tone develops in the lower extremities and lower body
before tone in the upper extremities and upper body develops
4-Control Medial control before lateral control.
-15-
Principles of development direction
5- Cervical control before rostral control.
6- Flexor muscle tone before extensor muscle tone.
7- Extensor antigravity control before flexor
antigravity control.
8- Weight bearing on flexed extremities before on
extended extremities.
9- Gross motor control before fine motor control.
10- Proximal control before distal control
-16-
Mobility, Stability, Controlled mobility, and
Skill,
Development of mobility.
Development of the stability.
Development of controlled mobility.
(Development of mobility superimposed
on stability).
Development of skill level
-17-
Motor Development Goals
The first goal of normal motor development is
control of the body against gravity.
A second goal of development is the ability to
maintain the body's center of mass within the base
of support.
A third goal of motor development is the
performance of intrasegmental and intersegmental
isolated movements.
-18-
-19-
Effective use of the hands depend on a complex
interaction of:
Visual skills.
Visual perceptual skills.
Visual-tactile integration.
Visual motor skills.
Fine motor skills.
-32-
Effective use of the hands depend on a complex
interaction of:
Somatosensory functions.
Sensory integration.
Cognitive skill.
Social factors.
Cultural factor.
Motor and physical factors.
-33-
Motor and physical factors:
- Integrity of the hand.
- R.O.M.
- Strength.
- Tone.
-34-
-35-
Fine motor skills include :
1-Basic reach:
Movement and stabilization of the arm and hand for the
purpose of contacting an object with hand.
2-Grasp:
Attainment of an object with the hand.
3-Carry:
The movement of the arm in space for the purpose of
transporting a hand-held object from one to another.
4-In hand manipulation:
The adjustment of an object within the hand after
grasp.
5-Release:
The international letting go of a hand held object at a
specific time and place.
6-Bilateral hand use:
The effective use of two hands together to accomplish
an activity. -36-
